Clinical outcomes of using demineralized dentin matrix bone grafts and HA-coated implants in medication-related osteonecrosis of the jaw

Bisphosphonates and denosumab are key osteoclast inhibitors used in osteoporosis treatments.While effective, these drugs can cause medication-related osteonecrosis of the jaw (MRONJ).Biofluorescence-imaging systems (BIS) were recently suggested to distinguish between pathologic and healthy bone during MRONJ surgery.This case report demonstrated a 79-year-old female with a ten-year history of bisphosphonate-developed MRONJ post-tooth extraction.BIS-guided surgery was performed, combined with hydroxyapatite (HA)-coated implants and a demineralized dentin matrix (DDM) graft.Follow-up at six months showed successful osseointegration and gingival healing without the recurrence of MRONJ or bone exposure.In conclusion, BIS is valuable for identifying pathologic bone in MRONJ surgery.The HA-coated implants and DDM have the potential for excellent tissue regeneration in MRONJ defects.(